Novel Vitreous Substitutes: The Next Frontier in Vitreoretinal Surgery

André Schulz; Kai Januschowski; Peter Szurman


Curr Opin Ophthalmol. 2021;32(3):288-293. 

In This Article


Recent preclinical studies confirm the potential of polymeric hydrogels to soon overcome the limitations of current clinically used vitreous substitutes. Here, a variety of different hydrogel systems is proposed, which can either be pregelled or applied as in situ gelling matrices crosslinked via chemical or physical processes. In principle, hydrogel-based vitreous substitutes may be used during any vitrectomy to replace the vitreous and perhaps lower the risk of postoperative complications such as cataract formation. To speculate, the new vitreous replacement strategies may also be beneficial in the treatment of macular holes. However, these potential effects need to be investigated in future trials. In addition, not only the tamponading properties of vitreous substitutes should be considered, but also the biomechanical and biochemical functions of the native vitreous. In particular, the material-based state-of-the-art should be extended by the inclusion of cells and/or cell products to the level of tissue engineering to further approach the native characteristics of a vitreous body.